Objective assessment of plaster cast quality in pediatric distal forearm fractures: Is there an optimal index?
| Autor: | Robinson Esteves Santos Pires, Luiz Henrique Penteado Silva, Pedro José Labronici, Fernando Claudino dos Santos Filho, Leonardo Termis Ferreira, Vinicius Schott Gameiro, Davi Coutinho Fonseca Fernandes Gomes |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Index (economics) Adolescent Radiography Spearman's rank correlation coefficient Likelihood ratios in diagnostic testing Objective assessment 03 medical and health sciences 0302 clinical medicine Recurrence Humans Medicine 030212 general & internal medicine Child Retrospective Studies General Environmental Science Fracture Healing Orthodontics Distal forearm 030222 orthopedics business.industry Forearm Injuries Reproducibility of Results Ulna Fractures Predictive value Surgery Patient Outcome Assessment Casts Surgical Child Preschool General Earth and Planetary Sciences Female Clinical Competence Radius Fractures business Brazil |
| Zdroj: | Injury. 48:552-556 |
| ISSN: | 0020-1383 |
| Popis: | Background Several so-called casting indices are available for objective evaluation of plaster cast quality. The present study sought to investigate four of these indices (gap index, padding index, Canterbury index, and three-point index) as compared to a reference standard (cast index) for evaluation of plaster cast quality after closed reduction of pediatric displaced distal forearm fractures. Methods Forty-three radiographs from patients with displaced distal forearm fractures requiring manipulation were reviewed. Accuracy, sensitivity, specificity, false-positive probability, false-negative probability, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were calculated for each of the tested indices. Results Comparison among indices revealed diagnostic agreement in only 4.7% of cases. The strongest correlation with the cast index was found for the gap index, with a Spearman correlation coefficient of 0.94. The gap index also displayed the best agreement with the cast index, with both indices yielding the same result in 79.1% of assessments. Conclusion When seeking to assess plaster cast quality, the cast index and gap index should be calculated; if both indices agree, a decision on quality can be made. If the cast and gap indices disagree, the padding index can be calculated as a tiebreaker, and the decision based on the most frequent of the three results. Calculation of the three-point index and Canterbury index appears unnecessary. |
| Databáze: | OpenAIRE |
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